Median raphe cysts are derived from the external paraurethral ducts and contain features that to our knowledge have not been previously reported.

Median raphe cysts are derived from the external paraurethral ducts and contain features that to our knowledge have not been previously reported.

Sir,We report on a case of mucinous adenocarcinoma arising from a fistula-in-ano, which formed a huge subcutaneous mass in the buttock.A 68-year-old diabetic man was referred to our hospital. Two years prior to the admission, the patient had first recognized a small subcutaneous nodule which gradually increased in size. On admission, he complained of a spontaneous pain. The mass measured 12×7 cm, and the covering skin had some ulcers with a foul smell.A contrast-enhanced transverse T1-weighted MR image (Fig. 1) revealed a huge cystic mass. The wall showed marked contrast uptake. Some enhancing solid components were also disclosed. The content showed homogenous low signal intensity on T1-weighted images, whereas a T2-weighted image (not shown) revealed marked hyperintensity.On another transverse image (Fig. 2), which was obtained at the cranial aspect of the lesion, a tubular structure was disclosed. This finding implied a fistula between the mass and the anus, although no direct continuity was identified.These MR findings in conjunction with the clinical course strongly sugEur Radiol (